Replacing a failing amalgam restoration with a bonded ceramic inlay
The problem
This patient attended The Clinic wishing to replace an ageing amalgam filling after cracks and recurrent decay were identified.
Although the tooth was not causing pain, the restoration had reached the end of its clinical lifespan. Decay had begun beneath the margins of the filling, increasing the risk of future fracture if left untreated. Many amalgam restorations are now decades old and, over time, can weaken the remaining tooth structure.
Because the existing restoration was extensive, simply replacing it with another filling would not have provided the same long-term strength or protection.
The treatment
The existing amalgam restoration was removed using the IAOMT SMART protocol, ensuring the highest standards of safety during mercury removal.
Once the restoration and all decay had been removed, the tooth was digitally scanned instead of using traditional impression materials. This produced an exceptionally accurate three-dimensional model, allowing the new restoration to be designed with outstanding precision.
As much healthy tooth structure as possible was preserved throughout treatment. A bonded ceramic inlay was recommended because it restores strength to the weakened tooth while providing an excellent long-term seal.
The digital scans
Scan 1 – After SMART amalgam removal
The first scan shows the tooth immediately after the amalgam filling and underlying decay had been removed.
The remaining tooth structure has been carefully preserved, providing a healthy foundation for the ceramic restoration.
Scan 2 – Preparing the tooth
The second scan demonstrates the refined preparation before the ceramic inlay was manufactured.
Digital scanning allows every contour of the tooth to be recorded with exceptional accuracy, ensuring the restoration fits precisely without the need for conventional impressions.
Scan 3 – The completed ceramic inlay
The final scan shows the ceramic inlay immediately after bonding.
The restoration reproduces the natural anatomy of the tooth while creating a precise adhesive seal. Unlike traditional amalgam fillings, bonded ceramic restorations reinforce the remaining tooth structure, helping restore strength and reducing the likelihood of future fracture.
The patient remained comfortable and symptom-free throughout treatment and now has a strong, natural-looking restoration designed for many years of service.
Treatment summary
| Treatment | SMART amalgam removal and bonded ceramic inlay |
| Technology used | Digital 3D intraoral scanning |
| Restoration | Custom ceramic inlay |
| Approach | Conservative, biological dentistry with maximum preservation of healthy tooth structure |
| Outcome | Strong, precisely fitting restoration with an excellent long-term seal |
Why this case matters
This case demonstrates how modern digital dentistry enables us to preserve healthy tooth structure while producing exceptionally accurate restorations.
By combining SMART amalgam removal, Digital 3D Dental Scanning, and adhesively bonded ceramic restorations, we can provide treatment that is conservative, comfortable and designed for long-term success.